Living With Children

Q:I am a grandmother with custody of my two grandsons, six-year-old twins. They play and communicate with each other just fine, but because of behavior problems at home and at school and the difficulties that they have relating to other children, they have been diagnosed with autism. What is your opinion of the diagnosis and what can I do to help them? Their therapist told me that the usual means of discipline wouldn’t work, but she has yet to tell me something that does.

A:All psychiatric (mental health) diagnoses, including autism—or, more accurately, autism spectrum disorder (ASD)—are based on third-party descriptions, not on observable data like the physical sciences. Thus, a diagnosis of ASD is a construct and subject to unreliability. One psychologist may render a diagnosis of autism while another may render a diagnosis of childhood bipolar disorder or oppositional defiant disorder for the same child.

There are several theories “out there” concerning autism that attribute its origin to genetics and other biological factors, but none of them have been proven conclusively. The dispute is not over what people are reporting, which is behavior problems; it is about speculative notions regarding the cause.

That is why I do not pay much attention to mental disorder diagnoses. One of the reasons why there are so many such diagnoses is that in today’s health care environment, insurance providers require that mental health professionals assign one or more diagnostic labels to anyone they see, whether for a mental or physical problem. And a psychologist won’t get reimbursed if he tells an insurance company that he is counseling so-and-so because of “problems in relationships.” Reimbursement depends on the psychologist diagnosing a patient with a recognized mental illness like depression.

Now to your grandchildren. It is not uncommon for twins during early childhood to develop a “secret language,” which they use to communicate just with each other. This phenomenon, estimated to occur with nearly half of all twins, including fraternal twins, is called cryptophasia. With or without cryptophasia, however, twin-to-twin behaviors can also develop that may ultimately interfere with normal peer relationships during early and middle childhood. In most cases, these difficulties are eventually outgrown, but this phenomenon should be taken into account when evaluating young twins who are having difficulty socializing with children outside the family.

If my hunch is correct, what people are seeing may not be autism. And the notion that normal means of discipline do not work with autistic children is pure balderdash. That says more about the person making such a claim than it says about your two boys. I have worked with a good number of parents who came to me with children diagnosed with ASD, and these kids are not a different species. They are human beings, and, therefore—when applied properly—the same principles that govern the successful discipline of any human child will work properly for them.

What does not work with ASD kids is acting like the diagnosis requires that they be handled with kid gloves. The proper discipline of a child, diagnosis or not, requires adults who are ready to step up to the plate and deliver unequivocal authority.

Kid gloves just will not do.

Family psychologist John Rosemond is the director of the Center for Affirmative Parenting in Gastonia, North Carolina. For information about his talks and workshops, contact Tracy Owens-Jahn at tracyjahn@sbcglobal.net or (817) 295-1751.